Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) Syndrome Induced by Imatinib

2019 ◽  
Vol 14 (2) ◽  
pp. 151-154 ◽  
Author(s):  
F. Zgolli ◽  
I. Aouinti ◽  
O. Charfi ◽  
T. Badri ◽  
S. Elaidli ◽  
...  
Keyword(s):  
Locally Advanced ◽  
Liver Function Tests ◽  
Exceptional Case ◽  
Favourable Outcome ◽  
Dress Syndrome ◽  
Drug Induced ◽  
Life Threatening ◽  
Drug Rash ◽  
Systemic Symptoms ◽  
European Registry

Introduction: Imatinib is the treatment of choice in patients with locally advanced or metastatic gastrointestinal stromal tumours (GIST). Clinical tolerance of imatinib is excellent except for the common adverse drug reaction (ADR). Drug rash with eosinophilia and systemic symptoms (DRESS syndrome) is a severe, potentially life-threatening drug-induced hypersensitivity reaction, characterized by cutaneous eruptions, fever, diffuse lymphadenopathy, along with eosinophilia, and elevated liver function tests. This ADR is rarely reported with imatinib. Only four cases of DRESS syndrome associated with imatinib have already been published. Case Report:We report an exceptional case of DRESS syndrome associated with imatinib in a 46 year-old woman with GIST. Two weeks after she had started imatinib therapy, she developed a skin rash, with eosinophilia and elevated liver tests. Plasma level of imatinib was within the therapeutic range. Imatinib was immediately discontinued. A favourable outcome was slowly observed after the drug had been stopped. Results and Conclusion: This case was scored three according to the European Registry of Severe Cutaneous Adverse Reactions Study Group (RegiSCAR). The Naranjo score for imatinib was five (probable).

scholarly journals Drug rash with eosinophilia and systemic symptoms, uncommon and commonly missed

2019 ◽  
Vol 6 (4) ◽  
pp. 1360
Author(s):  
Dona Das ◽  
Dinesh E. Ragav ◽  
A. Nasreen Begum
Keyword(s):  
Hypersensitivity Reaction ◽  
Blood Count ◽  
Dress Syndrome ◽  
Rare Form ◽  
Drug Induced ◽  
Life Threatening ◽  
Rapid Pace ◽  
Drug Rash ◽  
Systemic Symptoms ◽  
Kidney Liver

Drug Rash with eosinophilia and systemic symptoms, also called DRESS syndrome, is a rare form of drug induced hypersensitivity reaction that presents with skin eruptions, blood count abnormalities (eosinophilia) and internal organ involvement (lung, kidney, liver), making it life threatening at a rapid pace. The most commonly affected organ is liver, mimicking condition similar to acute hepatitis.

scholarly journals Case Reports of DRESS Syndrome and Symptoms Consistent with DRESS Syndrome Following Treatment with Recently Marketed Monoclonal Antibodies

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
James C. Di Palma-Grisi ◽  
Kesav Vijayagopal ◽  
Muhammad A. Muslimani
Keyword(s):  
Monoclonal Antibodies ◽  
Case Reports ◽  
Maculopapular Rash ◽  
Phase Iii ◽  
Dress Syndrome ◽  
Drug Induced ◽  
Diagnostic Reliability ◽  
Phase Iii Clinical Trials ◽  
Life Threatening ◽  
Systemic Symptoms

Background. Monoclonal antibodies constitute a potent and broadly tolerable drug class, representing for some conditions the first newly approved treatment in years. As such, many are afforded “fast-track” or “breakthrough therapy” designations by the U.S. Food and Drug Administration, leading to provisional approval before Phase III clinical trials are reported. Although these drugs are usually safe, some patients experience life-threatening complications—myositis and encephalitis have led to permanent or temporary recalls. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a hypersensitivity condition easily missed due to its long incubation period and nonspecific presentation. This minireview is primarily intended as an abbreviated guide for practitioners who may be using these powerful treatments. Methodology. We searched PubMed using a string of symptoms consistent with DRESS syndrome and monoclonal antibodies approved by the FDA since 2015. Then, we excluded studies reporting dermatological complications of reactivation of nonherpetic infection, immunodeficiency-related infection, or reactions to the injection site or infusion. We searched for and accessed prior reviews and background studies via PubMed, Mendeley, and Google Scholar. Results. Two cases of DRESS syndrome were identified in the literature, both the result of treatment with daclizumab. There was one additional case of encephalitis without cutaneous symptoms caused by daclizumab. Drug-induced hypersensitivity dermatitis was reported following treatment with nivolumab and two cases of combination treatment with ipilimumab and either nivolumab or durvalumab produced maculopapular rash and bullae in the first patient and lichenoid dermatitis and blisters in the second patient. Conclusions. Daclizumab was the only recently approved monoclonal antibody associated with DRESS syndrome as such. Limitations in the diagnostic reliability of DRESS syndrome as a clinical entity and the lack of negative clinical trial reporting suggest enhanced vigilance on the part of clinicians and regulators may be warranted.

scholarly journals LAMOTRIGINE INDUCED DRESS SYNDROME

2017 ◽  
Vol 10 (9) ◽  
pp. 3
Author(s):  
Saurab Agarwal ◽  
Balaji Ommurugan ◽  
Amita Priya ◽  
Mohan Amberkar ◽  
Meena Kumari Kamalkishore
Keyword(s):  
Early Detection ◽  
Early Diagnosis ◽  
Hypersensitivity Reaction ◽  
Rare Case ◽  
Dress Syndrome ◽  
Early Recovery ◽  
Life Threatening ◽  
Drug Rash ◽  
Systemic Symptoms ◽  
Life Threatening Event

Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome, is a type of hypersensitivity reaction, mainly due to anti-epileptic drugs. Lamotrigine is a newer broad spectrum antiepileptic that can be used in both children and adults. Lamotrigine induced DRESS syndrome is a rare case with incidence of 1/1000 to 1/10000. This syndrome manifests as rash, fever, tender lymphadenopathies, hepatitis, and eosinophilia. This case highlights the need for early diagnosis and treatment of such a rare and life threatening event because early detection of the condition leads to early recovery of the patient. Further re-exposure to the drug should be avoided.  

scholarly journals Successful Treatment of Antiepileptic Drug-Induced DRESS Syndrome with Pulse Methylprednisolone

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Celebi Kocaoglu ◽  
Ceyda Cilasun ◽  
Ece Selma Solak ◽  
Gulcan S. Kurtipek ◽  
Sukru Arslan
Keyword(s):  
Valproic Acid ◽  
Present Report ◽  
Treatment Modalities ◽  
Dress Syndrome ◽  
Internal Organs ◽  
Drug Induced ◽  
Pulse Methylprednisolone ◽  
Lymph Node Enlargement ◽  
Life Threatening ◽  
Systemic Symptoms

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but potentially life-threatening syndrome characterized by skin rash, fever, lymph node enlargement, and involvement of internal organs. It is most commonly induced by aromatic anticonvulsants and antibiotics. Nonaromatic anticonvulsants are rarely encountered as the causes of DRESS syndrome. In the present report, three discrete cases with DRESS syndrome developing due to three antiepileptic drugs, including valproic acid (nonaromatic), carbamazepine (aromatic), and lamotrigine (aromatic), and their treatment modalities were aimed to be discussed in light of the literature. To the best of our knowledge, our cases are the first children to be treated with pulse methylprednisolone in the literature.

scholarly journals Lamotrigine Associated DRESS Syndrome – a Case Report

2015 ◽  
Vol 7 (1) ◽  
pp. 23-33 ◽  
Author(s):  
Jagoda Balaban ◽  
Đuka Ninković-Baroš
Keyword(s):  
Case Report ◽  
Female Patient ◽  
Skin Rash ◽  
Respiratory Symptoms ◽  
Hypersensitivity Syndrome ◽  
Organ Involvement ◽  
Dress Syndrome ◽  
Drug Induced ◽  
Drug Rash ◽  
Systemic Symptoms

AbstractDrug-induced delayed multiorgan hypersensitivity syndrome, also known as drug rash (reaction) with eosinophilia and systemic symptoms (DRESS) syndrome, represents a drug-induced cluster of skin, hematologic and systemic symptoms. More than forty drugs have been associated with this syndrome. We present a case of DRESS syndrome suspecting that lamotrigine was directly responsible for the patient’s rash and other symptoms. A female patient presented with extensive skin rash, fever, hematologic abnormalities, organ involvement such as hepatitis, pancreatitis and respiratory symptoms. The symptoms developed four weeks after the initiation of the offending drug, and disappeared eight weeks after its discontinuation.

scholarly journals Rapid recovery of postnivolumab vemurafenib-induced Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome after tocilizumab and infliximab administration

2020 ◽  
Vol 8 (1) ◽  
pp. e000388 ◽  
Author(s):  
Natalia Maximova ◽  
Alessandra Maestro ◽  
Davide Zanon ◽  
Annalisa Marcuzzi
Keyword(s):  
Single Dose ◽  
Single Agent ◽  
Braf V600e ◽  
Dramatic Improvement ◽  
Dress Syndrome ◽  
Blood Concentrations ◽  
Tnf Α ◽  
Life Threatening ◽  
Drug Rash ◽  
Systemic Symptoms

BackgroundImmune checkpoint inhibitors such as nivolumab and targeted BRAF inhibitors have dramatically altered the treatment outcomes of metastatic melanoma over the past few years. Skin toxicity is the most common adverse event (AE) related to the commonly used BRAF inhibitor vemurafenib, affecting more than 90% of patients. Vemurafenib-related severe AEs with early onset are reported in patients who were previously treated with anti-programmed cell death-1 (anti PD-1) antibodies. A prolonged administration of systemic steroids is the first-line treatment of severe or life-threatening AEs. We report the case of a woman suffering from vemurafenib-related severe, rapidly worsening Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome, resolved in a few hours after single-dose administration of a combination of TNF-α antagonist infliximab with interleukin (IL)-6 receptor antagonist tocilizumab.Case presentationA 41-year-old woman treated with single-agent nivolumab presented with a melanoma progression. Biopsy samples were revised, revealing a BRAF V600E mutation. The patient was started on vemurafenib and cobimetinib treatment only 10 days after the last administration of nivolumab. On the third day of anti-BRAF therapy, profound lymphopenia was detected, and maculopapular eruption appeared afterward. Subsequently, the clinical conditions deteriorated further, and the woman was admitted on an emergency basis with high fever, respiratory and cardiocirculatory failure, diffuse rash, generalized edema, and lymphadenopathy. Diagnosis of DRESS syndrome with overexpressed capillary leakage was made. A single dose of tocilizumab was administered with an improvement of cardiocirculatory and renal function in a few hours. Because of worsening of liver function, skin lesions and mucositis, a single dose of infliximab was prescribed, and dramatic improvement was noted over the next 24 hours. Dabrafenib and trametinib were initiated, and coinciding with washout of infliximab from the patient’s blood, the drug toxicity recurred.ConclusionAnti-IL-6 and anti-TNF-α target treatment of very severe AEs may afford an immediate resolution of potentially life-threatening symptoms and reduce the duration and the costs of hospitalization. Maintenance of therapeutic infliximab blood concentrations permits an early switch to dabrafenib after vemurafenib-related AEs.

DRESS Syndrome Associated with Liposomal Amphotericin-B in a Kidney Transplant Patient: A case report

2021 ◽  
Vol 16 ◽  
Author(s):  
Ons Charfi ◽  
Syrine Ben Hammamia ◽  
Imen Aouinti ◽  
Widd Kaabi ◽  
Sarrah Kastalli ◽  
...  
Keyword(s):  
Case Report ◽  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
Fungal Infections ◽  
Exceptional Case ◽  
Favourable Outcome ◽  
Liposomal Amphotericin B ◽  
Kidney Transplant Patient ◽  
Dress Syndrome ◽  
Drug Induced

Introduction: Liposomal amphotericin B is a widely used broad-spectrum antifungal drug. It was developed to reduce nephrotoxicity and maximize the therapeutic utility of amphotericin B in the treatment of invasive fungal infections. Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a severe drug-induced hypersensitivity syndrome commonly associated with aromatic antiepileptic drugs. Liposomal amphotericin-B was associated with DRESS syndrome in only one case. Case Report: We report an exceptional case of possible DRESS syndrome associated with Liposomal amphotericin B in a 31-year-old male, renal transplant recipient. Seventeen days after starting Liposomal amphotericin B for visceral leishmaniosis, he developed a skin rash, with elevated liver tests. Liposomal amphotericin B was discontinued. A favourable outcome was slowly observed in one month. Results and Conclusion: This case was scored two (possible case) based on the criteria adopted by the European group RegiSCAR. The Naranjo score for Liposomal amphotericin B was four (possible).

scholarly journals DRESS syndrome due to clobazam: a case report

2020 ◽  
Vol 9 (12) ◽  
pp. 1906
Author(s):  
M. Faraz Qureshi ◽  
A. N. Dattatari
Keyword(s):  
Case Report ◽  
Hypersensitivity Reaction ◽  
Seizure Disorder ◽  
Dress Syndrome ◽  
Internal Organs ◽  
Idiosyncratic Reaction ◽  
Life Threatening ◽  
History Of ◽  
Drug Rash ◽  
Systemic Symptoms

Drug rash (or reaction) with eosinophilia and systemic symptoms (DRESS) is a potentially life-threatening hypersensitivity reaction to drugs characterized by rash, fever, lymphadenopathy, hematologic abnormalities, and involvement of internal organs. Initially coined in 1996, the term is used to refer to an idiosyncratic reaction to several drugs, the most common of which are carbamazepine, allopurinol, sulfasalazine, and phenobarbital. We report the case of DRESS related to clobazam in a 38-year-old female with a history of a complex seizure disorder.

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